The majority of Nigerians live in the rural underserved communities of the country and this comes with its attendant effects on all aspects of life, health, and wellbeing inclusive. Basic public facilities are usually not available in the very rural communities of Nigeria, and where there are, they are mostly under-maintained, undermanned, dilapidated, and vandalized. 

Road access, quality education, potable water, and power supply are usually not enjoyed by the people resident in rural communities. Worse still is the non-availability and non-accessibility to quality healthcare delivery. 

The lack of motivation and basic amenities together with poor remuneration of qualified health workers are a minus leading to their perennial absence to provide the services for which they have been trained to save lives via caring for the health needs of man in rural areas. 

Ours is the era of qualified health workers especially doctors and nurses migrating to the developing nations of the world not just in search of greener pastures but to also enjoy excellent working conditions. A few years ago, a particular graduating class of medical doctors was said to have all its members apply for foreign qualifying exams to be able to practice in the UK. 

To say the least, the present-day young surgeon would do all he can to practice where there is a 24-hour power supply than to start surgery using an old, poorly-maintained generator and finish the same surgery with the operating theatre attendant focusing his mobile phone’s flashlight on the surgical wound of the patient for the doctor to complete his surgery. This is an experience I’ve had a few times practicing in rural Nigeria. 

Providers of medical services have little or no motivation working where they enjoy no rewards for their labor or have the basic equipment to practice their profession. From experience, I can say that it is usually frustrating. 

Core rural areas in Nigeria are synonymous with poverty which ultimately comes with ignorance and disease, this trio has bidirectional relationships with one another and forms a vicious cycle which resultantly leads to an overwhelming prevalence of morbidity and mortality. For example, it is no longer news that two-thirds of childbirths occur in rural areas and are coordinated by unskilled attendants. Hence, it is not surprising that the World Health Organization recorded recently that “Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. Ninety-nine percent of all maternal deaths occur in developing countries. Maternal mortality is higher in women living in rural areas and among poorer communities. ” 

Sadly, alongside unskilled birth attendants, herbalists, and spiritual healers; traditional bone setters and other unskilled professionals are usually the custodians of the healthcare needs of the rural dwellers, with a few drugstores scattered here and there. Where there is a trained healthcare provider, he dabbles into fields and specialty of practice for which he is not qualified to serve. 

There is therefore the need for well-trained health professionals to practice in the rural areas. 

WHAT THEN IS THE WAY OUT? 

There should be a review of rural community syllabus and postings of students in the various fields of healthcare endeavor in our universities, nursing schools, and colleges of health technology. This seems ideal as the first step at introducing the student professional to the healthcare needs and culture of the rural populace. 

Provision of basic amenities that will better the lives of the populace and encourage doctors, nurses, pharmacists, etc, to work in rural areas should be a priority of the government. 

The government at all levels should motivate professionals to work in these communities and ensure training and retraining of the same. A special remuneration or competitive salary scale wouldn’t be a bad idea. Both government and nongovernmental organizations (NGOs) should partner together towards building and equipping health facilities in rural communities, this alongside the provision of essential drugs will motivate healthcare providers to do their job well. 

Rome, they say, wasn’t built in a day; and a journey of a thousand miles begins with an uncompromising step taken in the right direction with continuity and sustainability in place. This should come not just from the government at all levels and NGOs, but also from religious bodies and individuals with the wherewithal. 

Quality healthcare delivery to rural dwellers is not supposed to be rocket science, with the contribution of all and sundry, giving a little here and a little there, backed with political goodwill, determination, and grit, it is doable.